Healthcare Provider Details
I. General information
NPI: 1255752770
Provider Name (Legal Business Name): JKR ELDERCARE ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/31/2013
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2245 GATEWAY ACCESS PT SUITE 101
RALEIGH NC
27607-3077
US
IV. Provider business mailing address
104 ALDEN VILLAGE CT
CARY NC
27519-9793
US
V. Phone/Fax
- Phone: 919-746-7050
- Fax: 919-788-1440
- Phone: 919-746-7050
- Fax: 919-788-1440
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARCIA
K
JARRELL
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 919-746-7050